Care for children during epileptic seizures

Written by Hu Qi Feng
Pediatrics
Updated on September 20, 2024
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During an epileptic seizure, it is crucial to control the seizure promptly by using sedative and anticonvulsant medications. While administering these drugs, it is important to closely monitor for consistent breathing. Additionally, during a seizure, it is necessary to ensure that the airway remains clear, provide oxygen, and, if required, use mechanical ventilation to maintain airway patency. Prevent biting injuries to the tongue and position the head to one side so that secretions can flow out of the corner of the mouth, preventing reflux of stomach contents and risk of choking. Protect brain function and vital organs, and prevent cerebral edema. After the seizure has stopped, long-term administration of antiepileptic drugs should be continued to prevent recurrence.

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What are the symptoms of epilepsy in children?

Seizures in children manifest in various forms, but they all share characteristics of sudden onset, sudden cessation, and periodic occurrence. Common types include grand mal seizures, absence seizures, and benign childhood epilepsy. During a grand mal seizure, the child suddenly loses consciousness, stops breathing, turns blue-purple, pupils dilate, limbs stiffen, hands clench into fists, followed by spasmodic convulsions, foaming at the mouth, with the episode generally lasting 1-5 minutes. Absence seizures in children present as sudden loss of consciousness, interruption of activity, staring or rolling of the eyes, but without falling down or convulsing, lasting 1-10 seconds, with consciousness quickly returning after the episode. Benign childhood epilepsy seizures often involve twitching of one side of the face, lips, or tongue, possibly accompanied by abnormal sensations in the area, inability to speak, drooling, generally with clear consciousness, with episodes occurring more frequently at night.

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What are the early symptoms of epilepsy in children?

Epilepsy is a particularly common chronic disease in life. If the brain is underdeveloped and there are neurological disorders, it can cause epilepsy. What are the early symptoms of childhood epilepsy? The manifestations of a child's epileptic seizure are diverse, but all have the characteristics of sudden onset, sudden cessation, and periodic attacks. Common types in children include major seizures, absence minor seizures, and benign childhood epilepsy. During a major seizure, the child suddenly loses consciousness, breathing stops, the complexion turns cyanotic, the pupils dilate, the limbs stiffen, and the hands clench into fists, then switching to paroxysmal convulsions, foaming at the mouth, with the attack generally lasting 1-5 minutes. Children with absence seizures appear to suddenly lose consciousness, stop their activities, and stare upward or roll their eyes, but they do not fall down or convulse, lasting 1-10 seconds, with consciousness quickly recovering after the attack. Benign childhood epilepsy seizures often involve twitching of one side of the face, lips, and tongue, possibly accompanied by abnormal sensations in those areas, inability to speak, and drooling, typically with clear consciousness, and more frequently occurring at night.

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What causes epilepsy relapses?

Epilepsy is a clinical syndrome caused by highly synchronized abnormal discharges of brain neurons due to various reasons. Clinically, it is characterized by episodic, transient, repetitive, and stereotyped manifestations, making recurrence a characteristic of the disease itself. The location of the neurons with abnormal discharges and the range of the abnormal discharge waves vary, leading to different forms of seizure symptoms in patients. These can manifest in various ways, including sensory, motor, consciousness, psychiatric, behavioral, and autonomic nervous system dysfunctions, and may occur simultaneously. Each seizure and each type of seizure process is referred to as an epileptic seizure. Of course, a patient can experience one or several types of epileptic seizures, thus, recurrence is a characteristic of epilepsy itself.

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What are the symptoms of epilepsy in children?

Epilepsy is a chronic brain disorder caused by various etiologies, characterized by repetitive, episodic, and transient central nervous system dysfunction due to abnormal and excessively synchronized discharges of brain neurons. The clinical manifestations of childhood epilepsy are complex and varied, commonly including loss of consciousness, localized or generalized muscular rigidity or clonic convulsions, and sensory abnormalities; there may also be abnormal behaviors, emotional and perceptual disturbances, memory changes, and autonomic nervous system dysfunction.

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What are the signs before the onset of epilepsy?

Before the onset of epilepsy, most patients do not exhibit any signs and can suddenly experience an epileptic seizure. Different types of epilepsy have different symptoms. For example, during a major seizure, symptoms can include limb twitching, eyes rolling upwards, frothing at the mouth, clenched teeth, loss of consciousness, and abnormal blood pressure, which can lead to severe falls and injuries. During a minor seizure, the patient mainly shows transient loss of consciousness, objects in hand may suddenly drop, unresponsiveness when called, and a vacant stare. Most patients do not fall, and the symptoms generally last for only a few seconds to tens of seconds. If autonomic epileptic seizures are considered, symptoms may include nausea and vomiting. Psychotic symptom seizures can present with hallucinations and delusions.